What Can We Do To Help American Women Nurse Their Babies?

When I went to a friend’s birthday party a few weeks ago there was a mom there bottle feeding her 3-month-old. At my 10-year-old daughter’s gymnastics meet last Saturday I saw two tiny twins being bottle fed.

It makes me sad to see such small babies being fed formula from bottles.

A new study by researchers at Harvard Medical School, published April 5th in Pediatrics, “The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis,” concluded that the United States would save over $13 billion a year and prevent more than 900 infant deaths if American women would simply comply with the medical recommendation to breastfeed for the first six months.

When my mother was having my three older brothers and me, the nurses in the hospital were surprised that she wanted to nurse us. They thought she was crazy and she should just give us formula. But my mother insisted. She’s a biologist. She knew the best thing for calves was cow milk, the best thing for sheep was ewe milk and the best thing for humans was human milk. She nursed two of my brothers and me until we were four months old and she nursed my second oldest brother until he was six months old, hand expressing milk after she was hospitalized for appendicitis when Jeremy was a newborn.

I know breastfeeding can be hard. With my oldest my unconditioned nipples cracked and bled. It was so painful at first that I cried when she latched on. Then there was the engorgement. My breasts were as hard and as big as boulders when my milk came in a few days after she was born. But little by little we both got the hang of it. I learned to put my pinkie in her mouth to pop her off so she wouldn’t chomp on my nipples with her gums. She learned to open her mouth wide to latch on. The cracks healed. I nursed through two subsequent pregnancies and when she finally weaned she was four years old and we were both ready.

I nursed my second daughter through a painful yeast infection that refused to respond to any of the recommended treatments. She and I decided she would wean when she turned three, four months after her baby brother was born. Though nursing him at first was easy, when he was about a year old I got another yeast infection. My nipple cracked so badly I could separate it from my breast. Nothing worked. Not gentian violet. Not nystatin. But finally a lactation consultant suggested grapefruit seed extract: I was to drink it three times a day and apply it in a solution of one drop of grapefruit seed extract in five drops of water after every nursing. Within two days the infection–and the shooting pains it caused–was gone. Etani nursed past his fourth birthday also.

Unlike when I was growing up, most people in the medical establishment recognize how important breastfeeding is for the health of newborns and the health of the mother.

Yet the study concluded that U.S. breastfeeding rates are “suboptimal.”

Though the American Academy of Pediatrics (AAP) recommends that women breastfeed exclusively for the first six months of life and continue to nurse for “the first year and beyond, as long as mutually desirable for the mother and child,” a little less than 75 percent of mothers in the United States breastfeed their babies at birth. What is even sadder, only 32 percent of those moms are breastfeeding exclusively by the time the baby is three months old.

That means that the majority of three month old infants in America, babies who are too young to sit up by themselves, are no longer breastfeeding.

Breastfeeding is the best choice for so many reasons. It enhances a baby’s immune system, giving the infant antibodies, enzymes, and even entire immune cells to ward off infection. Breast-fed babies don’t have nearly as many lung, ear, and urinary tract infections. They don’t have diarrhea. Their poop doesn’t smell bad. They aren’t ingesting soy proteins or cow milk proteins. They have far fewer allergies than bottle-fed babies. And they aren’t being exposed to other harmful substances in formula, like residual pesticides and chemical additives.

Breast-fed babies don’t die as often as bottle-fed babies.

The study’s authors specify that bottle-fed babies are much more likely to die from Sudden Infant Death Syndrome (SIDS), necrotizing enterocolitis (NEC, a disease seen primarily in preterm infants), and lower respiratory tract infections such as pneumonia.

And breastfeeding makes babies smarter. According to Lise Eliot, Ph.D., a neuroscientist at the Chicago Medical School, and author of What’s Going On In There: How the Brain and Mind Develop in the First Five Years of Life, the single most important thing you can do to help your baby’s brain is breastfeed. Eliot writes: “…human milk specifically benefits a baby’s brain development … breast-fed babies are actually smarter than bottle-fed children” (184 her emphasis).

If a woman doesn’t breastfeed is it her fault? I don’t think so. Not everyone can breastfeed. And few new moms have the support they need to keep nursing when breastfeeding gets difficult. Sadly, we live in a society that in so many ways does not support new moms and dads.

This is a social problem not an individual problem. American hospitals should not be allowed to give formula samples to new moms, for one thing. American women should get at least one year of paid maternity leave so they can continue to breastfeed, for another. We should help women who can’t nurse by giving them breast milk for their babies instead of formula. Women who can’t nurse should not be made to feel badly or feel guilty but they should be able to get human milk for their human child. Lactating moms could even help each other by nursing each other’s babies.

What do you think? How can we help more women nurse their babies? Why do you think almost 25 percent of American women don’t even try to nurse and so many more stop so soon? Do you/did you nurse your infant? Share your thoughts in the comment section below.

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22 thoughts on “What Can We Do To Help American Women Nurse Their Babies?”

  1. I nursed all three of my babies, although, at the time, people tried to discourage me from doing so, in France, where we lived. One of my husband’s cousins even warned me it would make my breasts sag!!! I loved nursing and was very sad when that period of my life was over. I agree about paid maternity leave. Women with jobs outside the home must find it more complicated to nurse. I wonder if that isn’t one of the main factors? I will be interested to see what suggestions your readers come up with.
    .-= Alexandra´s last blog ..Spiffed-Up Green Room Ready for New Season =-.

  2. I had a smooth, easy time nursing the first three (each of whom self-weaned at some point in the first or second year), but I was totally derailed by #4. Because of her serious health issues and month-long hospital stay as a newborn, I was never able to get her to latch on properly (despite plenty of encouragement from the nurses at Children’s). I ended up pumping for a full year, but never established a good supply — even with the help of mother’s milk tea, fenugreek, warm compresses, deep breathing, plenty of water, and finally, domperidone. I felt like such a failure. Still, I have to say in all my years of breastfeeding (beginning in 1991), I got nothing but encouragement — from friends, family, doctors, etc. — along the way. In fact, the only person who seemed put off by my choice was my mother, who formula-fed us all. I never criticized her choice, but I think she took *my* decision to breastfeed as some sort of public renunciation of her. Honestly, one HUGE reason we chose to breastfeed is one that rarely gets much mention — it’s FREE. As a 20-year-old unmarried first-time mother and full-time college student, the prospect of free food for our baby was a BIG deal!

  3. I think there is a lot of misinformation out there. WIth my first, I went back to school when she was 6 wks old and thought that I would be able to breastfeed and bottlefeed. Wrong. That ended at about 5 mos. All the books and info I had said it was possible but it just really isn’t.

    I think that I had a decreased milk supply with both kids, but no one ever asked, told me that, or helped me with it, even when my second child was in the bottom 10 percentile for weight.

    I never was able to pump or express much and it would have been nice to have support and help for that too.

  4. I started out with good intentions … nursed my son for the first 4 weeks. But he developed symptoms of pyloric stenosis after a month ( a rare stomach deformity requiring surgery) and I ended up having to bottle feed him after that. A difficult time.
    .-= Cindy L.´s last blog ..Hometown pride =-.

  5. I was blessed to have an easy time nursing from the beginning. I was however encouraged by my mother to suppliment some feedings with formula. I choose not to do that, my daughter never drank from a bottle. I was lucky enough to be able to stay home with her and be available when she wanted to nurse. Now that she is a little over 2 Ive noticed that I do not get the same support I did when she was an infant. People are constantly telling me that she is too old to nurse, and if I dont stop now she will nurse forever. Its hurtful. Thank you for this article.

  6. First, let me say to all of you ladies who commented before me- KUDOS! You all did what you could for your children. No matter how hard things got, with and without support, you provided an awesome start for your babies! You are inspiring, and your stories should be told to moms to be everywhere. Maybe a simple video of diverse moms, sharing their experiences good and bad would be a good start. Something to stick in those goody bags your OB gives you on your first visit…

    I nursed all five of mine at least two years each, through subsequent pregnancies, and two at once. I was 21 with my first in 1991, and my pediatrician was at first impressed with my choice (since I was so “young”). By the time my daughter was 4 months old, she was telling me we needed to talk about weaning, and at 6 months she told me I was “ruining” my daughter by continuing to bf… Talk about mixed messages. I wonder how many women have had similar experiences?

    Nursing was always such a pleasure, a blessing.

    I have never understood the attitude that it is inconvenient (how the heck is mixing a bottle at 3am any more convenient than cuddling up with you sweet baby?), or restricting. I have certainly been guilty of looking down my nose at mothers who don’t bf. I am trying to remedy that, because I know there is a lot of misinformation out there. Honestly, there are very FEW times a mother cannot nurse or provide breast milk for her baby at all, but they are just as extreme as they are rare.

    … See More

    How to get more women to bf? I think you hit the number one reason- ban gifts of formula from the hospital. WHO Baby Friendly Hospitals need to be the norm. Again, another case of Big Pharma/food companies co-opting health- from birth. I also think La Leche and affiliates need to start a campaign, to get more info into doctors’ offices, commercials, web stuff…

    I don’t know. I think those of us who bf are already inclined to do so because of our belief systems, the way we were raised, our health consciousness. That is not to say people cannot be taught differently, but when the mass opinion is that formula is just as good (if not better), because of media and what they see in public, we are fighting popular opinion. I have hope, though…

  7. One of the biggest factors, as I see it, is that of the strange way we talk about breastfeeding – even in your own article there are a number of examples of this, which will become apparent when you read the article below. To be clear, the misinformation actually comes from breastfeeding proponents as well as its detractors. The “breast is best” spiel is deeply misguided and we need to work on this, I think.

    Anyway: the article I’m talking about has been around a while: it’s called “Watch Your Language” by Diane Wiessinger (http://www.motherchronicle.com/watchyourlanguage.html) and it makes the point far more coherently than I can.

  8. I agree with everything the article says; however, if you see a baby being given a bottle, don’t automatically assume it’s formula like author does at the beginning of the article. When we go out, because I’m not always sure I can find a place to nurse, I give my son a bottle that has pumped milk. I plan to nurse until he’s at least a year old, and having the flexibility of giving him pumped milk in a bottle, in addition to feeding from the breast, is going to make it a lot easier to do that.

    As for making it so that more women breastfeed longer, I think the new health care bill took a good step in the right direction. I do not intend to start a health care debate here because I know some of it is controversial, but the bill does require employers of a certain size to provide a place for women to pump other than a public restroom. I think part of the reason only 32 percent are still nursing at 3 months is because more women have to return to work than they did previously. I’m fortunate in that I’m able to stay home with my son, so breastfeeding for me is much easier than if I’d gone back to work. So to increase these numbers, we need to make it easier for women in the workforce to pump.

  9. My children are grown and having children of their own now, but many years ago I decided to breastfeed them for a full year. I had so many challenges in the beginning and no one to help me problem solve. I was just stubborn and determined and somehow I found solutions that helped me muddle through. I’m now a certified lactation counselor and I cringe to think of the methods I used to problem solve. I don’t really know how I was ultimately successful since I broke all the rules, except that I was quite determined. Sometimes I wonder in our current culture if we have created an environment in which we send out the message that everything should be easy and without effort. Maybe we aren’t doing a very good job of educating about breastfeeding’s benefits so moms will push past the hard things to get to the other side where it becomes easier. I battle physicians who sabotage mother’s milk supply by administering hormonal birth control. Mothers battle those who think breastfeeding is disgusting and should be hidden away in a bathroom or otherwise out of sight. They battle having to problem solve alone without enough lactation assistance and often give up for lack of help. I started a support group for moms and have a constant rotation of about a dozen moms attending. I wish I could get to all the ones having to return to work and help them know they CAN pump, work and continue to breastfeed in many instances.

  10. As a midwife, I strive every day to provide the education and support for women and their babes to successfully breastfeed. We are able to provide continuity of care which starts with prenatal education, encouraging skin to skin bonding and breastfeeding in the first 30-60 minutes after birth, four postpartum visits in the woman’s home during the first ten days and 24 hr on call for question/concerns. Ontario midwifery clients have a >90% breastfeeding rate at 6 wks!! Sadly, our care ends at 6 weeks postpartum but before women leave my office, I ensure that full-term breastfeeding is discussed…with as many family members present as possible. I want women to have knowledgeable and supportive family and friends there beside them along the way. We also provide an excellent KFL&A Health Unit brochure about breastfeeding and a second one that is specifically about breastfeeding beyond 6 months. I feel blessed to be in a position to support women and babes as they strive to breastfeed successfully…and of course, I enjoy the times I am honoured to simply witness the wonder!!

    Personally, my journey towards midwifery was planted by my own first experience with birthing, breastfeeding and mothering. Unfortunately, my daughter’s chance to first breastfeed (after she was born in 1992) was delayed for medical reasons (mine) and it took her three days to latch on. In that time, I was offered a case of formula numerous times by hospital staff “just in case breastfeeding didn’t work out”. She weaned just shy of her 4th birthday! I wish I knew what fueled my perseverance as I’d like to bottle it and ship it out for anyone who needs to keep going not only in the absence of support, but in the presence of undermining comments/behaviour. My second child is currently breastfeeding and just celebrated his third birthday…three days after the arrival of his baby brother who is currently asleep on my chest as I type. I feel blessed and privileged to have these moments with my children and to contribute to their lifelong health (and mine) on a daily basis.

  11. I’m a nursing mom to my 10 month old daughter and absolutely love this bonding time that we share. We started off with many challenges but through support from my family and guidance from a lactation consultant both my daughter and I have been much happier!

    I fortunate to live in an area that does support breastfeeding and I also work for a company that provides “lactation” rooms for nursing moms. I returned to work when my daughter was 4 months old and my extremely supportive husband brings her to me at lunchtime so I can nurse her vs pumping. I would stay home with her full-time but I am the insurance holder in our family so I had to return part-time.

    I plan on nursing her as long as I possible can, she definitely isn’t showing any signs of weening which makes me a happy mama. It is not unheard of in our community to see a 4 year old tandem nursing next to their newborn sibling.

    For the record I would fully support having 1 year off, I was fortunate with the 4 months I was able to take…and it definitely wasn’t long enough in my opinion!

  12. I just read this very interesting article by one of the authors of the Pediatrics study.


    The experience she describes as the ideal hospital/breastfeeding experience is the one I had in my only hospital birth (out of four births). This did not occur in this country, but in Japan, at a big city hospital. Birth was natural (really no anesthesia option) with midwives, baby was calmly put to breast, roomed in….the hospital even provided cloth diapers! They assumed mothers would breastfeed. There are plenty of formula fed babies there too, but the basic underlying assumption that mothers will breastfeed makes a big difference in a lot of crucial ways.

    While I didn’t give birth to my first three babies in hospitals, I did stay in several different (US) hospitals during one of the pregnancies due to a complication, and had a chance to ask a lot of questions about their support for breastfeeding. I realized that in those hospitals, a mother would have to be her own best advocate in order to protect the breastfeeding relationship with her new baby.
    .-= Christine at Origami Mommy´s last blog ..Close Enough to Kiss =-.

  13. I think having more knowledgeable and encouraging medical staff educate and support mom through her pregnancy and birth would be super helpful! I work as a nurse in a pediatric hospital, and had to seek out and pay for my own lactation education to be better prepared to support moms of sick babies to breastfeed. And breastmilk is even more important for this very at risk population!

  14. Re why people don’t try: I don’t know.

    Re: why people stop so soon. Now that one I can help you with. Because it’s hard! My first week I had blocked ducts and bleeding nipples and a baby who didn’t latch right and who nursed constantly…. if I had not been so dedicated, I would have quit. Even with the visiting nurses association and le leche, we really don’t have enough support for nursing mothers. I remember on day 2 at home calling every single phone number in the book in search of someone who would help me figure out what I was doing wrong. I kept getting “we can come to your house in 2 weeks” or “come to our next meeting.” Stuff like that. If one of the nurses at my daughter’s pediatrician’s office had not been a lactation consultant, I would have definitely quit.

    This is something that we need to teach women as a requirement before giving birth (part of prenatal care). And nurses at hospitals need to be better trained in how to teach mothers how to do it and how to give proper support. And there needs to be better follow up care. And when a mother goes to her GYN office two days after birth, pulls up her shirt and shows the nurse crusty bloody nipples, the nurse should do something beyond giving her nipple cream!

    And those of us who know how to nurse need to help our friends who don’t know. We need a community of breast confident mothers who can teach the breast confident.
    .-= Alisa Bowman´s last blog ..Should you role play? =-.

  15. When my first son was born, I tried to breastfeed but was plagued by so many of the things you describe, and soon gave up. I was so overwhelmed and did not know where to turn. The nurses at the hospital were of no help whatsoever and I was sadly unaware of le leche or any other organizations that could help; my doctor did not even speak to me about it. What a shame. I do think that more support and guidance and education must be given to pregnant women, not only to help them learn about their pregnancy, but to learn how to care for the child once it is born.
    .-= Sheryl´s last blog ..What Do You Really Love to Do? =-.

  16. Before giving birth to my daughter, I was absolutely determined to breastfeed because of all the reasons detailed in this article and also those mentioned by the mamas who commented. I’ll say it again: I was determined!

    My daughter’s birth was beautiful. We were really set up to succeed in breastfeeding, so I was baffled when she wasn’t gaining much weight after she was born. When she was a few days old she became fussy at the breast, especially at nighttime. I had very, very little experience with babies, no experience with newborns, and had never even seen a woman breastfeeding without being covered. Because of my lack of experience I also didn’t recognize that the amount of time she spent nursing every day was unusual.

    When she was four weeks old I had to start supplementing. I was absolutely beside myself. I couldn’t believe I was having to give my tiny, sweet baby formula, but she barley weighed more than her birth weight and I started to worry that she would suffer cognitively.

    I saw a lactation consultant but she didn’t tell me what was wrong. I did a lot of research online and looked at pictures breasts that had insufficient glandular tissue. This was my problem, too. I was even more devastated, even though I knew that my struggle wasn’t because of anything I was doing wrong. I encountered the knowledge that I have a congenital defect, and no one really knows why this happens to women.

    At first I used an SNS. It was embarrassing to have to explain to people, even friends, that I wasn’t making enough milk. Sometimes my daughter hated trying to get the formula out of the SNS tube taped to my breast and she fussed. My mom criticized me for not wanting to just give her a bottle.

    When I went back to work at 12 weeks I started using a bottle because I was embarrassed to use the SNS at work where people would see me with the funny contraption (no privacy in my office setting) and I also didn’t want to feel like anyone was looking at my breasts. My milk supply dwindled with the use of bottles, but I managed to partially nurse my baby until she was 7 months old. I made very little milk, but even 4 oz. a day is better than nothing.

    I am relatively new to my small, rural town and didn’t/don’t know any mamas well enough to ask for donated milk (it seems like a lot to ask!). Unless my daughter has allergies to formula or is very sick I cannot get a prescription for brest milk, and anyway it is very, very expensive and the milk bank nearest to us is very low on supply.

    I am both happy and sad when I read articles about the benefits of breastfeeding. I am happy because I know that the vast majority of women have the capability to fully breastfeed their children, in spite of road bumps along the way. I want women to know that they can do it!

    I am sad because I will never have this experience. It is true that bottle feeding is very, very hard, much harder than breastfeeding in many cases. I make a special formula for my daughter because I am so concerned about commercial formulas, and this has prevented me from traveling by plane with my daughter since she was born because we can’t transport the ingredients.

    I wish there was help for me and my daughter. I worry so much about my daughter’s health, but I don’t know how to get breast milk to feed her.

    Thank you for this article. I am so glad you encourage women to do what is best for them and for their babies.

  17. i am blessed to live in Montreal, Canada. Here we have one year of maternity leave payed! and the father has paternity leave of 5 weeks… this helps a lot to make breastfeeding the norm.

    Also it is ILLEGAL here for hospitals to give formula!

    There is a state policy to promote breastfeeding and all hospitals and doctors HAVE to promote it.

    When you are pregnant, all women here receive a free book from the government about how to raise kids. almost 1/3 of the book is about breastfeeding and how important it is to bf exclusively for the first 6 months.

    Another thing that helps and that is very different here compared to some States of the US is that breastfeeding is not seen as something you have to hide for. I can bf anywhere.

    Maybe this will change when my son will be older (he know is 14 months and has never had a bottle).

    I think that what has helped me a lot is to bf exclusively and very very frequently. I believe that spaced (eg: every 4 hours) bf is a cause of “breast deseases”… we are “designed” to bf very frequently, day and night (i still bf around 4 times every night).

    I love to bf and it has also contributed to delay my ability to have another child as i am still so commited to my baby. I still have not had my periods! I won’t complain about that :o)

    I think things will change slowly but surely and that bf rates will climb. Unfortunately in southern countries (like in asia) there is massive advertisement etc for formula and they are going straight into the wall our parent’s generation have been in where doctors would say it’s better that breastmilk!

    anyone who has breastfed knows, feels, how close you get whith your baby… i just love it!
    .-= Joanna´s last blog ..Accoucher SEULE! =-.

  18. When my baby was born in the late seventies, Similac was the new miracle formula, boiling bottles was replaced by the new plastic multi-bottle automatic sterilizers and glass bottles were safely(??) replaced with plastic ones within which you heated the milk. (And, Pampers disposable diapers were all the rage). In retrospect, they even had a strong toxic odor. Thank goodness times and attitudes have changed. Questioning the trend being one of them.

    I was only eighteen with no mother to comfortably ask for advice. Yet, at least, something inside me told me that my breasts had a functional purpose and were filling up with human, non-synthetic milk for a reason. It was not easy, but, I nursed for a few months until I was advised to replace that with Similac for a road trip. My supply seemed to dry up and I gave up. But, at least there was a head start the natural way. I mean, who even came up with fake mother’s milk?

  19. You wrote: “What is even sadder, only 32 percent of those moms are breastfeeding exclusively by the time the baby is three months old.

    That means that the majority of three month old infants in America, babies who are too young to sit up by themselves, are no longer breastfeeding.”

    Not necessarily. I think a lot of mothers choose to do a mix of formula and breastfeeding, whether necessary or not.
    .-= Globetrotter Parent´s last blog ..Organic, homeopathic products, dirt cheap? =-.

  20. I have so many emotions running though me after reading this article and all the testimonials.

    1. Sadness-With little support I abandoned breastfeeding my daughter at 4 weeks. I was pumping and feeding through bottles, and when I went back to work there was no space or time provided to pump, so when the freezer stock ran dry we switched to formula. Almost instantly my daughter began having hard stools, difficulty passing, days between BM, etc. Several calls to pediatrician and nurses resulted in being told that it was ‘normal’ to go up to TEN DAYS without passing a stool. On what planet?! I felt like a failure and a bad mother.

    2. Jealousy-Oh, that I had been more determined! I have several friends that had no problems breastfeeding, and some that never tried. I have a girlfriend that just decided to stop BFing one day because she thought it was time. She decided she was done and switched to formula. At 6months! In my head I ran her up and down a list of ‘if I could go back’ scenarios but luckily kept my mouth shut. She’s my best friend and nothing is worth an argument. Her son is healthy and happy.

    3.Knowledge-I love my daughter. She was an unexpected gift from God whom I was woefully unprepared for. She was my first ‘pancake’. Looking ahead, I now know what amazing resources there are available, and what rights I have. Eventual Baby #2 will be exclusively breastfeed for as long as they like. And besides all that, I now also know that breast feeding is that best way to lose baby weight anyway!

  21. As a midwife and mother of (now big boys) 3 who all weaned between 2 yrs and 2.5 years, I am glad and humbled that i live in Aotearoa/New Zealand. We have a breastfeeding culture, paid maternity leave for 14 weeks, and the ability to take unpaid leave with your position protected for a year, and we are signatories to the Code of Marketing of Breastmilk substitutes. I am saddened to hear of the influence of marketing of formula in the US. I think encouraging (pressuring?) your Ministry of Health to be signatories would go a long way. Of course, midwifery care for the majority of women would also help!

    We are lucky in NZ. What a blessing breastfeeding is. I was especially glad to be “still” breastfeeding (the term nursing is not so common in NZ) my 17 month old when he had a stroke (CVA). It made calming an agitated, irritable toddler easier, and meant that some procedures such as an echo (ultrasound of his heart) and CT scan could be done without anaesthesia – only feeding. I am also convinced that the fatty acids and intimate relationship we had meant his brain recovered.

  22. Strange!.I like checking out your blog for the reason that you usually write great articles.Very nice writeup… I am excited to bookmark this website. I think I shall subscribe to the websites feed too. Great work once again. Family tip of the week – A great dentist is hard to find. When you do get one do not be mean to them ….

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